ATTORNEY NEWSLETTER
Four Former Employees Blew Whistle On Alleged Fraud
Allegations Of Illegal Kickbacks And Unnecessary Services
Medically Unnecessary Pain Cream Prescriptions
Healthcare fraud costs the government billions every year, and private individuals do more to recover that money for the government than the government itself does. Last year, over 80% of the $2 billion the government recovered in fraud cases came from the actions initiated by private individuals under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq. Individuals bringing the cases are referred to as “relators.” 31 U.S.C. § 3730(b). Individuals with knowledge of the fraud can be rewarded if the government recovers against the offending companies. 31 U.S.C. § 3730(d). In cases of healthcare fraud, defendants may also violate the Anti-Kickback Statute, 42 U.S.C. § 1320a-7(b), and Stark Law, 42 U.S.C. § 1395nn, and a complaint would include those statutory violations as well as the FCA cause of action. If you have credible information of healthcare fraud in Orange County, Los Angeles or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).
Chiropractor Settles FCA Allegations
In a recent settlement announced by the U.S. Department of Justice,[1] a federal court entered a $9 million civil consent judgment for the United States against a chiropractor for allegedly engaging in a conspiracy to pay illegal kickbacks and to defraud healthcare programs by billing for unnecessary medical services. The defendant chiropractor owned and operated pain management clinics, laboratories and pharmacies throughout several States. The government alleged that the chiropractor caused the submission of false claims to federal health care programs arising from kickbacks he paid for urine drug testing (UDT) referrals in violation of the Anti-Kickback Statute; referrals prohibited under the Stark Law from physicians with whom McCollum had financial relationships; and claims for UDT and other services that were not medically necessary and that lacked a legitimate medical purpose. The government alleged that defendant offered kickbacks in the form of a direct bill program whereby his laboratory gave referring providers an opportunity to earn revenue generated from their referrals as an inducement for those providers to refer all of their federally-insured UDT patients to his lab. He also allegedly caused medically unnecessary prescriptions for pain creams often without the knowledge or approval of the patients’ healthcare providers and regardless of whether the prescription had a legitimate medical purpose. The settlement also resolves allegations that the supplier billed Medicare for products without regard to the patients’ eligibility.
Relator Claims For Wrongful Termination
Although the relators in this case were former employee, often current employees are the individuals who have the original information of the fraud. Current employees, agents, executives, officers, and others are protected from employer retaliation for bringing false claims qui tam cases. 31 U.S.C. § 3730(h). But despite this legal protection, employers continue to retaliate against whistleblowers. If you are fired because you brought any fraud to light, however, you can fight back under the False Claims Act which prohibits retaliation against you for exposing the wrongdoing. You may be entitled to sue your employer in court and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.
Contact Us
If you have credible information of government fraud call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program.
[1] Evans Law Firm, Inc. was not involved in the cases in any way. The qui tam cases are captioned United States ex rel. Rauch, et al. v. Oaktree Medical Centre, P.C., et al., No. 6:15-cv-01589-DCC (D.S.C.); United States ex rel. Mathewson v. Dr. Daniel A. McCollum, et al., No. 6:17-CV-01190-DCC (D.S.C.); and United States ex rel. Hawkins v. Pain Management Associates of the Carolinas, LLC, et al., No. 8:18-cv-02952-DCC (D.S.C.).
